Optimization of the “Perth CT” Protocol for Preoperative Planning and Postoperative Evaluation in Total Knee Arthroplasty
Аутори
Stojadinović, MilicaMašulović, Dragan
Kadija, Marko
Milovanović, Darko
Milić, Nataša
Marković, Ksenija
Ciraj-Bjelac, Olivera
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Background and Objectives: Total knee arthroplasty (TKA) has become the treatment of choice for advanced osteoarthritis. The aim of this paper was to show the possibilities of optimizing the Perth CT protocol, which is highly effective for preoperative planning and postoperative assessment of alignment. Materials and Methods: The cross-sectional study comprised 16 patients for preoperative planning or postoperative evaluation of TKA. All patients were examined with the standard and optimized Perth CT protocol using advance techniques, including automatic exposure control (AEC), iterative image reconstruction (IR), as well as a single-energy projection-based metal artifact reduction algorithm for eliminating prosthesis artifacts. The effective radiation dose (E) was determined based on the dose report. Imaging quality is determined according to subjective and objective (values of signal to noise ratio (SdNR) and figure of merit (FOM)) criteria. Results: The effective radiation dose with... the optimized protocol was significantly lower compared to the standard protocol (p < 0.001), while in patients with the knee prosthesis, E increased significantly less with the optimized protocol compared to the standard protocol. No significant difference was observed in the subjective evaluation of image quality between protocols (p > 0.05). Analyzing the objective criteria for image quality optimized protocols resulted in lower SdNR values and higher FOM values. No significant difference of image quality was determined using the SdNR and FOM as per the specified protocols and parts of extremities, and for the presence of prothesis. Conclusions: Retrospecting the ALARA (‘As Low As Reasonably Achievable’) principles, it is possible to optimize the Perth CT protocol by reducing the kV and mAs values and by changing the collimation and increasing the pitch factor. Advanced IR techniques were used in both protocols, and AEC was used in the optimized protocol. The effective dose of radiation can be reduced five times, and the image quality will be satisfactory.
Кључне речи:
optimization / Perth CT protocol / total knee arthroplastyИзвор:
Medicina, 2024, 60, 1, 98-
DOI: 10.3390/medicina60010098
ISSN: 1648-9144
PubMed: 38256359
Scopus: 2-s2.0-85183187464
Колекције
Институција/група
VinčaTY - JOUR AU - Stojadinović, Milica AU - Mašulović, Dragan AU - Kadija, Marko AU - Milovanović, Darko AU - Milić, Nataša AU - Marković, Ksenija AU - Ciraj-Bjelac, Olivera PY - 2024 UR - https://vinar.vin.bg.ac.rs/handle/123456789/12721 AB - Background and Objectives: Total knee arthroplasty (TKA) has become the treatment of choice for advanced osteoarthritis. The aim of this paper was to show the possibilities of optimizing the Perth CT protocol, which is highly effective for preoperative planning and postoperative assessment of alignment. Materials and Methods: The cross-sectional study comprised 16 patients for preoperative planning or postoperative evaluation of TKA. All patients were examined with the standard and optimized Perth CT protocol using advance techniques, including automatic exposure control (AEC), iterative image reconstruction (IR), as well as a single-energy projection-based metal artifact reduction algorithm for eliminating prosthesis artifacts. The effective radiation dose (E) was determined based on the dose report. Imaging quality is determined according to subjective and objective (values of signal to noise ratio (SdNR) and figure of merit (FOM)) criteria. Results: The effective radiation dose with the optimized protocol was significantly lower compared to the standard protocol (p < 0.001), while in patients with the knee prosthesis, E increased significantly less with the optimized protocol compared to the standard protocol. No significant difference was observed in the subjective evaluation of image quality between protocols (p > 0.05). Analyzing the objective criteria for image quality optimized protocols resulted in lower SdNR values and higher FOM values. No significant difference of image quality was determined using the SdNR and FOM as per the specified protocols and parts of extremities, and for the presence of prothesis. Conclusions: Retrospecting the ALARA (‘As Low As Reasonably Achievable’) principles, it is possible to optimize the Perth CT protocol by reducing the kV and mAs values and by changing the collimation and increasing the pitch factor. Advanced IR techniques were used in both protocols, and AEC was used in the optimized protocol. The effective dose of radiation can be reduced five times, and the image quality will be satisfactory. T2 - Medicina T1 - Optimization of the “Perth CT” Protocol for Preoperative Planning and Postoperative Evaluation in Total Knee Arthroplasty VL - 60 IS - 1 SP - 98 DO - 10.3390/medicina60010098 ER -
@article{ author = "Stojadinović, Milica and Mašulović, Dragan and Kadija, Marko and Milovanović, Darko and Milić, Nataša and Marković, Ksenija and Ciraj-Bjelac, Olivera", year = "2024", abstract = "Background and Objectives: Total knee arthroplasty (TKA) has become the treatment of choice for advanced osteoarthritis. The aim of this paper was to show the possibilities of optimizing the Perth CT protocol, which is highly effective for preoperative planning and postoperative assessment of alignment. Materials and Methods: The cross-sectional study comprised 16 patients for preoperative planning or postoperative evaluation of TKA. All patients were examined with the standard and optimized Perth CT protocol using advance techniques, including automatic exposure control (AEC), iterative image reconstruction (IR), as well as a single-energy projection-based metal artifact reduction algorithm for eliminating prosthesis artifacts. The effective radiation dose (E) was determined based on the dose report. Imaging quality is determined according to subjective and objective (values of signal to noise ratio (SdNR) and figure of merit (FOM)) criteria. Results: The effective radiation dose with the optimized protocol was significantly lower compared to the standard protocol (p < 0.001), while in patients with the knee prosthesis, E increased significantly less with the optimized protocol compared to the standard protocol. No significant difference was observed in the subjective evaluation of image quality between protocols (p > 0.05). Analyzing the objective criteria for image quality optimized protocols resulted in lower SdNR values and higher FOM values. No significant difference of image quality was determined using the SdNR and FOM as per the specified protocols and parts of extremities, and for the presence of prothesis. Conclusions: Retrospecting the ALARA (‘As Low As Reasonably Achievable’) principles, it is possible to optimize the Perth CT protocol by reducing the kV and mAs values and by changing the collimation and increasing the pitch factor. Advanced IR techniques were used in both protocols, and AEC was used in the optimized protocol. The effective dose of radiation can be reduced five times, and the image quality will be satisfactory.", journal = "Medicina", title = "Optimization of the “Perth CT” Protocol for Preoperative Planning and Postoperative Evaluation in Total Knee Arthroplasty", volume = "60", number = "1", pages = "98", doi = "10.3390/medicina60010098" }
Stojadinović, M., Mašulović, D., Kadija, M., Milovanović, D., Milić, N., Marković, K.,& Ciraj-Bjelac, O.. (2024). Optimization of the “Perth CT” Protocol for Preoperative Planning and Postoperative Evaluation in Total Knee Arthroplasty. in Medicina, 60(1), 98. https://doi.org/10.3390/medicina60010098
Stojadinović M, Mašulović D, Kadija M, Milovanović D, Milić N, Marković K, Ciraj-Bjelac O. Optimization of the “Perth CT” Protocol for Preoperative Planning and Postoperative Evaluation in Total Knee Arthroplasty. in Medicina. 2024;60(1):98. doi:10.3390/medicina60010098 .
Stojadinović, Milica, Mašulović, Dragan, Kadija, Marko, Milovanović, Darko, Milić, Nataša, Marković, Ksenija, Ciraj-Bjelac, Olivera, "Optimization of the “Perth CT” Protocol for Preoperative Planning and Postoperative Evaluation in Total Knee Arthroplasty" in Medicina, 60, no. 1 (2024):98, https://doi.org/10.3390/medicina60010098 . .